Abstract
Purpose
To report our first cases of robotic laparoendoscopic single-site (R-LESS) radical nephrectomy with the novel Da Vinci R-LESS platform (Intuitive Surgical, Sunnyvale, CA).
Methods
Six radical nephrectomies were performed with R-LESS Da Vinci single-site port and instruments. Data concerning patients characteristics, indication of surgery, operative and postoperative outcomes were collected.
Results
All procedures were completed successfully. Two patients required the placement of an additional port. Median operative, docking and console times were 179 min (range 120–318), 19 min (range 15–24) and 129 min (range 100–264), respectively. Median blood loss was 100 ml (range 50–800). No significant robotic-related problem was noticed during the procedures. There was no operative or major postoperative (Clavien >2) complication. Median length of hospital stay was 3 days.
Conclusion
Our initial experience of R-LESS radical nephrectomies with the novel Da Vinci platform shows that the procedure is feasible. Indications, safety and place of the technique will be confirmed with growing experience.
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References
Kaouk JH, Autorino R, Kim FJ et al (2011) Laparoendoscopic single-site surgery in urology: worldwide multi-institutional analysis of 1076 cases. Eur Urol 60:998–1005
Autorino R, Cadeddu JA, Desai MM et al (2011) Laparoendoscopic single-site and natural orifice transluminal endoscopic surgery in urology: a critical analysis of the literature. Eur Urol 59:26–45
Escobar PF, Fader AN, Paraiso MF, Kaouk JH, Falcone T (2009) Robotic-assisted laparoendoscopic single-site surgery in gynecology: initial report and technique. J Minim Invasive Gynecol 16:589–591
Stein RJ, White WM, Goel RK, Irwin BH, Haber GP, Kaouk JH (2010) Robotic laparoendoscopic single-site surgery using GelPort as the access platform. Eur Urol 57:132–136
White MA, Haber GP, Autorino R et al (2010) Robotic laparoendoscopic single-site radical prostatectomy: technique and early outcomes. Eur Urol 58:544–550
Han WK, Kim DS, Jeon HG et al (2011) Robot-assisted laparoendoscopic single-site surgery: partial nephrectomy for renal malignancy. Urology 77:612–616
Haber GP, White MA, Autorino R et al (2010) Novel robotic da Vinci instruments for laparoendoscopic single-site surgery. Urology 76:1279–1282
Kaouk JH, Autorino R, Laydner H et al (2012) Robotic single-site kidney surgery: evaluation of second-generation instruments in a cadaver model. Urology 79:975–979
Cestari A, Buffi NM, Lista G et al (2012) Feasibility and preliminary clinical outcomes of robotic laparoendoscopic single-site (R-LESS) pyeloplasty using a new single-port platform. Eur Urol 62:175–179
Wolters U, Wolf T, Stutzer H, Schroder T (1996) ASA classification and perioperative variables as predictors of postoperative outcome. Br J Anaesth 77:217–222
Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213
Micali S, Pini G, Teber D et al (2013) New trends in minimally invasive urological surgery. What is beyond the robot? World J Urol 31:505–513
Autorino R, Kaouk JH, Stolzenburg JU et al (2013) Current status and future directions of robotic single-site surgery: a systematic review. Eur Urol 63:266–280
Joseph RA, Goh AC, Cuevas SP et al (2010) “Chopstick” surgery: a novel technique improves surgeon performance and eliminates arm collision in robotic single-incision laparoscopic surgery. Surg Endosc 24:1331–1335
White MA, Autorino R, Spana G et al (2011) Robotic laparoendoscopic single-site radical nephrectomy: surgical technique and comparative outcomes. Eur Urol 59:815–822
Vizza E, Corrado G, Mancini E et al (2013) Robotic single-site hysterectomy in low risk endometrial cancer: a pilot study. Ann Surg Oncol 20:2759–2764
Kroh M, El-Hayek K, Rosenblatt S et al (2011) First human surgery with a novel single-port robotic system: cholecystectomy using the da Vinci single-site platform. Surg Endosc 25:3566–3573
Morel P, Hagen ME, Bucher P, Buchs NC, Pugin F (2011) Robotic single-port cholecystectomy using a new platform: initial clinical experience. J Gastrointest Surg 15:2182–2186
Konstantinidis KM, Hirides P, Hirides S, Chrysocheris P, Georgiou M (2012) Cholecystectomy using a novel single-site® robotic platform: early experience from 45 consecutive cases. Surg Endosc 26:2687–2694
Cela V, Freschi L, Simi G, Ruggiero M, Tana R, Pluchino N (2013) Robotic single-site hysterectomy: feasibility, learning curve and surgical outcome. Surg Endosc 27:2638–2643
Spinoglio G, Lenti LM, Maglione V et al (2012) Single-site robotic cholecystectomy (SSRC) versus single-incision laparoscopic cholecystectomy (SILC): comparison of learning curves. First European experience. Surg Endosc 26:1648–1655
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Mathieu, R., Verhoest, G., Vincendeau, S. et al. Robotic-assisted laparoendoscopic single-site radical nephrectomy: first experience with the novel Da Vinci single-site platform. World J Urol 32, 273–276 (2014). https://doi.org/10.1007/s00345-013-1161-9
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DOI: https://doi.org/10.1007/s00345-013-1161-9